scholarly journals Adnexal torsion during pregnancy: A rare cause of acute abdomen

2019 ◽  
Vol 18 (2) ◽  
pp. 49-52
Author(s):  
Konstantinos Zacharis ◽  
Stavros Kravvaritis ◽  
Theodoros Charitos ◽  
Eleni Chrysafopoulou ◽  
Anastasia Fouka
Keyword(s):  
Emergency Department ◽  
Acute Abdomen ◽  
Adnexal Mass ◽  
Doppler Velocimetry ◽  
Vascular Pedicle ◽  
Second Trimester ◽  
Ovarian Mass ◽  
Adnexal Torsion ◽  
Venous Obstruction ◽  
Sonographic Examination

Ovarian torsion is caused by rotation of the ovary or adnexa with the vascular pedicle on its axis resulting in arterial and venous obstruction. Here we report a case of a pregnant woman presented to the emergency department in early second trimester with acute abdomen. History revealed the presence of an ovarian mass detected by ultrasonography 6 months before pregnancy. Sonographic examination showed right adnexal mass with abnormal Doppler velocimetry and thus immediate laparotomy was decided. Right salpingo-oophorectomy was performed and post-operative course of the patient was uneventful. According to this case, adnexal torsion should not be eliminated from differential diagnosis when it comes to pregnant women with acute abdomen.

scholarly journals Susceptibility-weighted MR sequence for the evaluation of ovarian masses with torsion

2020 ◽  
Vol 93 (1109) ◽  
pp. 20200110
Author(s):  
Mayumi Takeuchi ◽  
Kenji Matsuzaki ◽  
Masafumi Harada
Keyword(s):  
Adnexal Mass ◽  
Imaging Finding ◽  
High Signal ◽  
Vascular Pedicle ◽  
Adnexal Torsion ◽  
Venous Thrombus ◽  
Gynecologic Emergency ◽  
Cystic Masses ◽  
Induced Signal ◽  
Ovarian Masses

Objective: Adnexal torsion is a rare gynecologic emergency caused by twisting of an adnexal mass. Twisted vascular pedicle is the most specific imaging finding for adnexal torsion, however, identification of twisted vascular pedicle can be challenging. The purpose of this study is to evaluate the feasibility of susceptibility-weighted MR sequence (SWS) for the diagnosis of adnexal torsion. Methods: MR imaging including SWS (SWAN: susceptibility-weighted angiography) of surgically proven four benign ovarian masses with torsion (one acute and three subacute to chronic torsions) were retrospectively evaluated. Three cystic masses and one solid mass were included in this study. Results: High signal intensity venous thrombus within the twisted vascular pedicle on T1-weighted imaging (T1WI) was detected in three lesions with subacute to chronic torsion (75%) but not in one lesion with acute torsion, whereas susceptibility-induced signal voids within the twisted vascular pedicle on SWAN were detected in all four lesions (100%). Conclusion: The demonstration of venous thrombus in the twisted vascular pedicle by SWS may be diagnostic for adnexal torsion. Advances in knowledge: SWS can detect blood products sensitively and can reveal venous thrombus in the twisted vascular pedicle, which may be helpful for the diagnosis of adnexal torsion.

Outcome in laparoscopic management of persistent adnexal mass during the second trimester of pregnancy

2004 ◽  
Vol 18 (9) ◽  
pp. 1354-1357 ◽  
Author(s):  
P. M. Yuen ◽  
P. S. Ng ◽  
P. L. Leung ◽  
M. S. Rogers
Keyword(s):  
Adnexal Mass ◽  
Second Trimester ◽  
Laparoscopic Management

Feasibility of 3-Dimensional Sonographic Examination of the Fetal Secondary Palate During the Second-Trimester Anatomy Scan

2011 ◽  
Vol 30 (12) ◽  
pp. 1619-1624 ◽  
Author(s):  
Waldo Sepulveda ◽  
Amy E. Wong ◽  
Francella Castro ◽  
Begoña Adiego ◽  
Pilar Martinez-Ten
Keyword(s):  
Second Trimester ◽  
Sonographic Examination ◽  
3 Dimensional ◽  
Secondary Palate

scholarly journals Antenatal Spontaneous Renal Forniceal Rupture Presenting as an Acute Abdomen

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Jennifer Travieso ◽  
Omar M. Young
Keyword(s):  
Acute Abdomen ◽  
Delayed Diagnosis ◽  
Kidney Injury ◽  
Percutaneous Nephrostomy ◽  
Gravid Uterus ◽  
Intractable Pain ◽  
Second Trimester ◽  
Improved Outcomes ◽  
Maternal And Neonatal Outcomes ◽  
In Pregnancy

Background. Renal forniceal rupture is a lesser-known cause of acute abdomen in pregnancy. The ureteral compression by the gravid uterus places pregnant women at a higher risk. Sequelae in pregnancy could include intractable pain, acute kidney injury, and preterm birth.Case. A 22-year-old primigravida with no prior medical history presented with an acute abdomen in her second trimester. The diagnosis of renal forniceal rupture was made by a radiologist using MRI. A percutaneous nephrostomy catheter was placed, and the patient’s pain was relieved. She subsequently delivered at term.Conclusion. Upon presentation of an acute abdomen in pregnancy, providers may not include renal forniceal rupture in their differential as readily as obstetric or gynecologic causes, resulting in delayed diagnosis, unnecessary invasive interventions, and potentially adverse maternal and neonatal outcomes. Increasing provider awareness could result in improved outcomes.

Diagnostic dilemma of isolated fallopian tube torsion

2021 ◽  
Vol 14 (7) ◽  
pp. e242682
Author(s):  
Michael Gerard Baracy Jr ◽  
Janie Hu ◽  
Holly Ouillette ◽  
Muhammad Faisal Aslam
Keyword(s):  
Acute Abdomen ◽  
Fallopian Tube ◽  
Differential Diagnoses ◽  
Adnexal Torsion ◽  
Normal Appendix ◽  
Diagnostic Dilemma ◽  
Perimenopausal Women ◽  
Adolescent Patients ◽  
History Of

Paratubal cysts are fluid-filled sacs that grow adjacent to the fallopian tube which can rarely result in torsion. Isolated fallopian tube torsion (IFTT) is a gynaecological emergency that warrants urgent laparoscopic detorsion to salvage the affected tube. IFTT has a proclivity to affect adolescents between the ages of 12 and 15 years and is rarely seen in premenarchal or perimenopausal women. Due to a lack of pathognomonical features, IFTT is difficult to diagnose. Adnexal torsion, including IFTT is a surgical diagnosis and no clinical or imaging criteria is sufficient to diagnose IFTT. Urgent laparoscopy and detorsion are required for preservation of the affected fallopian tube. However, given the diagnostic ambiguity, IFTT diagnosis is often delayed. IFTT should be included in the differential diagnoses for adolescent patients with acute abdomen when imaging demonstrates a normal appendix and ovaries. We report a 15-year-old girl with a 4-day history of abdominopelvic pain and bilateral paratubal cysts resulting in right IFTT.

scholarly journals Atypical Vasa Previa in a Velamentous Cord Insertion Identified During Sonographic Examination

2019 ◽  
Vol 36 (1) ◽  
pp. 73-78
Author(s):  
Amanda Gandhi
Keyword(s):  
Patient Outcomes ◽  
Second Trimester ◽  
American Institute ◽  
Sonographic Examination ◽  
Vasa Previa ◽  
Chorionic Membrane ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Fetal Vessel ◽  
Velamentous Cord Insertion

Vasa previa is a life-threatening complication of a velamentous cord insertion. Understanding variations of this condition is vital to ensuring optimal patient outcomes. The case presented is of a 27-year-old primigravida woman whose condition was diagnosed during her second-trimester obstetric sonographic examination. The case demonstrated an unusual variation of vasa previa, in which a single fetal vessel separated from the membranous insertion located near the fundal placenta and traversed posteriorly through the chorionic membrane to within 0.83 cm of the internal os. The case was followed with the most up-to-date standards recommended by the American Institute of Ultrasound in Medicine.

scholarly journals Arabin Cerclage Pessary as a Treatment of an Acute Urinary Retention in a Pregnant Woman with Uterine Prolapse

2013 ◽  
Vol 2013 ◽  
pp. 1-2
Author(s):  
Alicia Martínez-Varea ◽  
Francisco Nohales-Alfonso ◽  
Vicente José Diago Almela ◽  
Alfredo Perales-Marín
Keyword(s):  
Emergency Department ◽  
Pregnant Woman ◽  
Acute Urinary Retention ◽  
Uterine Prolapse ◽  
Second Trimester ◽  
Vaginal Infection ◽  
Successful Pregnancy ◽  
Predisposing Factor ◽  
Bladder Drainage ◽  
One Year

A 35-year-old gravida 7, para 1, and abortus 5 female with hypogastric pain and inability to void urine after 14 + 3 weeks of amenorrhea was examined in the emergency department. One year before, a uterine prolapse had been diagnosed in another hospital. Examination showed a uterine prolapse grade 2 with palpable bladder. The patient was unable to void urine. After a manual reduction of the uterine prolapse, the patient underwent an emergency catheterization for bladder drainage. A Hodge pessary (size 70) was placed, which led to spontaneous micturitions. Due to the persistence of the symptoms the following day, Hodge pessary was replaced by an Arabin cerclage pessary. Although the pessary could be removed from the beginning of the second trimester, due to the uterine prolapse as a predisposing factor in the patient and the uncomplicated progression of pregnancy, it was decided to maintain it in our patient. Therefore, Arabin cerclage pessary allowed a successful pregnancy outcome and was not associated with threatened preterm delivery or vaginal infection.

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